Week 2 - Chapter 24: Asepsis and Infection Control

Which mask should the nurse don when caring for a client with tuberculosis? No mask is needed Low-efficiency particulate air (LEPA) Filtered respirator Surgical mask

Filtered respirator

The client presents to the Emergency Department reporting fever, chills, and a productive cough. The chest x-ray shows an area of infiltrate, and the primary care provider prescribes a broad spectrum antibiotic. Which client teaching statement from the nurse is most appropriate regarding the prescribed drug? "Pneumonia is usually caused by multiple organisms." "This antibiotic causes fewer side effects than a narrow spectrum antibiotic." "This antibiotic is the best choice since the causative organism is not known." "Drug resistance can develop when the wrong antibiotic is used for pneumonia."

"This antibiotic is the best choice since the causative organism is not known."

The nurse is caring for a client admitted with tuberculosis (TB). What would be the best action by the nurse? Have the client wear a mask during care. Apply a nonparticulate (N-95) respirator when entering the room. Wear a protective gown and gloves with any direct contact. Wear a mask with face shield during invasive procedures.

Apply a nonparticulate (N-95) respirator when entering the room.

The nurse working with the hospital's infection control team is attempting to decrease the transmission of healthcare-associated pathogens. Which intervention will be most effective? Limiting visitors to family members over the age of 18 Encouraging visitors to adhere to isolation precautions Incentivizing health care workers to utilize hand hygiene Revising the facility's infection control protocols

Incentivizing health care workers to utilize hand hygiene

A nurse has been exposed to urine while changing the linens of a client's bed. Which guideline is followed for performing hand hygiene after this client encounter? Pat dry with a paper towel, beginning with the forearms and moving down to fingertips. Use an alcohol-based hand rub to decontaminate the hands. Keep hands lower than elbows to allow water to flow toward fingertips. Remove all jewelry, including wedding bands, before hand washing.

Keep hands lower than elbows to allow water to flow toward fingertips.

The nurse is caring for a client who has active tuberculosis and is under airborne precautions. The health care provider prescribes a computed tomography (CT) examination of the chest. Which action by the nurse is appropriate? Request that the examination be done at the bedside. Notify the CT department in advance so other clients and staff can be removed from the area. Question the need for the examination, because the client must remain under airborne precautions. Place a surgical mask on the client and transport to the CT department at the specified time.

Place a surgical mask on the client and transport to the CT department at the specified time.

A client has tested positive for methicillin-resistant Staphylococcus aureus after being swabbed on admission to the hospital. Bacterial resistance to antibiotics is an example of: Aerobic activity Means of transmission Spore production Survival adaptation

Survival adaptation

A nurse is caring for a client who is diagnosed with tuberculosis. Which nursing intervention promotes infection control based on nursing practice standards for safety? The nurse places the client in a private room with monitored negative air pressure. The nurse places the client in a private room with the door open. The nurse keeps visitors 3 feet away from the infected person. The nurse uses droplet precautions when providing care for the client.

The nurse places the client in a private room with monitored negative air pressure.

The nurse is providing an in-service educational program for the interprofessional health care team about infection control precautions. What teaching will the nurse include? Select all that apply. Use equipment repeatedly on clients with similar conditions. Wear personal protective equipment (PPE). Use standard precautions only for clients with infection. Keep client's environment clean. Practice hand hygiene.

Wear personal protective equipment (PPE). Practice hand hygiene. Keep client's environment clean.

The nurse conducting a hand hygiene in-service determines that the participants need additional education when they state that the use of an alcohol-based hand rub is appropriate in which situation? After direct contact with clients After completing a wound dressing Before direct contact with clients When hands are visibly soiled

When hands are visibly soiled

Which client would require a negative flow room? a 3-year-old with influenza A and a productive cough an 81-year-old man with active tuberculosis and a productive cough a 4-year-old boy with meningitis a 21-year-old man with latent tuberculosis who is postoperative following repair of a femoral fracture

an 81-year-old man with active tuberculosis and a productive cough

The nurse is reviewing the plan of care for assigned clients. Which client has the highest risk for developing an infection? a school-age child who is current with immunizations an adolescent who has a right radial fracture a middle-aged adult who takes prescribed medication to control blood pressure an older adult client with a history of heart failure

an older adult client with a history of heart failure

A nurse is taking care of a client with tuberculosis who has developed resistance to the ordered antibiotic. Which type of client is most likely at increased risk for infection? a. pregnant woman b. adult c. older adult d. child

c

For which client would the use of standard precautions alone be appropriate? a. a client with TB who needs medications administered b. a child with chickenpox who is treated in the emergency room c. an incontinent client in a nursing home who has diarrhea d. a client with diphtheria who needs p.m. care

c

Which client would require a negative flow room? a. a 4-year-old boy with meningitis b. a 21-year-old man with latent tuberculosis who is postoperative following repair of a femoral fracture c. an 81-year-old man with active tuberculosis and a productive cough d. a 3-year-old with influenza A and a productive cough

c

The client is an employee on the medical unit at the local children's hospital. The nurse is an occupational health nurse educating the client on various routes of exposure. The nurse knows that as a hospital employee, the client is most susceptible to infection by what mode of transmission? vehicle droplet contact airborne

contact

The nurse is caring for an older adult with a recurrent wound infection. Which precautions will the nurse begin? airborne contact droplet none

contact

The nurse is caring for a client that is suspected of having a latex allergy. What item of personal protective equipment should the nurse use with caution? a. Goggles b. Pillows c. Gowns d. Surgical masks

d

A nurse is explaining the different procedures used to break the chain of infection to a nursing student. In which link in the chain of infection should a nurse provide special attention to the respiratory and gastrointestinal tracts? susceptible host exit route infectious microorganism vehicle of transmission

exit route

The nurse is preparing discharge instructions for a family member who will be caring for a client with an abdominal incision. Which concept should be the priority in the teaching plan? sterile technique hand washing signs of healing putting on gloves

hand washing

Which nursing action is a component of medical asepsis? drawing blood from a central line insertion of an intravenous catheter insertion of an indwelling urinary catheter handwashing after removing gloves

handwashing after removing gloves

A nurse is taking stock of the equipment in the room of an older adult client with pneumonia who has been on parenteral nutrition for a long time. Which equipment can transmit infection to older adult clients? indwelling catheter bath blanket specimen containers face shields

indwelling catheter

A client has sexual intercourse with someone infected with HIV. The vehicle of transmission is:

semen

The nurse is caring for a client with tuberculosis. Which precautions will the nurse select for this client? droplet contact airborne standard

airborne

The nurse is caring for an older adult with pulmonary tuberculosis. Which precautions will the nurse begin? none droplet contact airborne

airborne

Question 7 of 20 For which client would the use of standard precautions alone be appropriate? a client with diphtheria who needs p.m. care a client with TB who needs medications administered a child with chickenpox who is treated in the emergency room an incontinent client in a nursing home who has diarrhea

an incontinent client in a nursing home who has diarrhea

A client has a diagnosis of HIV and has been admitted to the hospital with an opportunistic infection that originated with the client's normal flora. Why did this client most likely become ill from his resident microorganisms? a. The client's normal flora began producing spores b. The client's immune system became further weakened c. The resident microorganisms mutated and became virulent d. The client's normal flora proliferated because of a nutritional deficit

b

A client is admitted to the hospital with tuberculosis. Which statement by the nurse explains how to reduce the risk of transmission to others? a. "Under no circumstances should you touch the client." b. "All visitors who enter the room must wear special masks." c. "Everyone who enters the room must wear a gown and gloves." d. "No visitors are allowed in the room to decrease the spread of disease."

b

A nurse prefers to use an alcohol-based hand rub when providing care for clients. In which case is this practice contraindicated? a. The nurse finishes client care and hands are not visibly soiled. b. The nurse is caring for a client with a C. difficile infection. c. The nurse performs routine care and is moving to another client. d. The nurse finishes cleaning a client's table.

b

An acute medicine unit of a hospital currently has a number of clients who have tested positive for methicillin-resistant Staphylococcus aureus (MRSA). Which measures should the nursing staff prioritize in preventing the spread of MRSA to clients who are currently MRSA-negative? a. constant use of gloves when on the unit b. diligent handwashing practices c. prophylactic antibiotic therapy for MRSA-negative clients d. reduced length of stay for MRSA-positive clients

b

Any microorganism capable of disrupting normal physiologic body processes is a: a. virus. b. pathogen. c. bacterium. d. fomite.

b

The nurse is setting up a sterile field to perform a catheterization when the client touches the end of the sterile field. What would be the nurse's next appropriate action? a. Proceed with the procedure since it was only touched by the client. b. Discard the sterile field and the supplies and start over. c. Call for help and ask for new supplies. d. Change the sterile field, but reuse the sterile equipment.

b

To eliminate needlesticks as potential hazards to nurses, the nurse should: a. place the uncapped needle on a tray and carry it to the medicine room for disposal. b. immediately deposit uncapped needles into a puncture-proof plastic container. c. stick the uncapped needle into a Styrofoam block and deposit it in a plastic container. d. slide the needle into the cap and deposit it in a puncture-proof plastic container.

b

Nurses working in bed management are assigning clients from the emergency room to semiprivate rooms. Clients with which two diagnoses are appropriate to room together, based on safety and infection control standards? Appendectomy and a draining leg ulcer positive for methicillin-resistant Staphylococcus aureus Tuberculosis and pneumonia Reactive airway disease and exacerbation of chronic obstructive pulmonary disorder (COPD) Clostridium difficile and diabetic ketoacidosis

Reactive airway disease and exacerbation of chronic obstructive pulmonary disorder (COPD)

Personal protective equipment (PPE) is used in health care facilities for primarily which reason? To protect both the staff and clients from becoming infected by one another To protect staff members from becoming infected by clients To protect clients from becoming infected by staff members To protect the hospital from legal liability

To protect both the staff and clients from becoming infected by one another

A client is diagnosed with hepatitis C. What statement made by the client indicates that further education is required regarding the transmission of the virus? "I probably got the virus when I sat on the toilet seat in a dirty bathroom." "I may have gotten the virus when I got a tattoo while I was in prison." "I can't transmit the virus other people if I shake their hands." "I received a blood transfusion in 1989, which could be a factor in contracting the disease."

"I probably got the virus when I sat on the toilet seat in a dirty bathroom."

The nurse is educating a client with human immunodeficiency virus (HIV) about ways the virus can be transmitted. Which statements made by the client demonstrates the education provided was effective? Select all that apply. "If I sweat at the gym and someone touches me, he or she can contract the virus." "If someone is exposed to my blood, I may transmit the virus to him or her." "I may transmit the virus if I share needles with another person." "I may transmit the virus to my child during pregnancy and childbirth." "If someone uses the bathroom after I have been on the toilet, he or she can catch the virus."

"If someone is exposed to my blood, I may transmit the virus to him or her." "I may transmit the virus to my child during pregnancy and childbirth." "I may transmit the virus if I share needles with another person."

A nurse is preparing an operating room theatre for a surgical procedure. Which point regarding the principles of surgical asepsis should the nurse keep in mind when preparing sterilized surgical instruments? When a sterile item touches something that is not sterile, it may not be contaminated. Any partially uncovered sterile package need not be considered contaminated. Sterility may not be preserved even when one sterile item touches another sterile item. A commercially packaged surgical item is not considered sterile if past expiration date.

A commercially packaged surgical item is not considered sterile if past expiration date.

Which practice is a correct application of infection control practices? A nurse performs hand washing each time the nurse removes a pair of gloves. A nurse dons a pair of gloves prior to any client contact. A nurse rinses hands thoroughly after the application of an alcohol-based hand rub. A nurse uses an alcohol-based hand rub each time that the nurse's hands are visibly soiled.

A nurse performs hand washing each time the nurse removes a pair of gloves.

The nurse is preparing to don a gown to care for a client requiring contact precautions. When should the nurse don the gown? After taking the client's pulse After entering the client's room Before entering the client's room Before taking the client's pulse

Before entering the client's room

The nurse is preparing to don sterile gloves for a procedure that requires surgical asepsis. Place the following steps in the order that the nurse should take when donning sterile gloves. Use all options. 1. carefully open the inner package taking care not to touch the inner surface of the package or gloves 2. with the thumb and forefinger, grasp the folded cuff of the glove, insert fingers while pulling the glove over the hand 3. place the fingers of the gloved hand inside the cuff of the remaining glove and insert the fingers while stretching it over the hand 4. adjust gloves on both hands if necessary, touching only sterile areas w other sterile areas

Carefully open the inner package taking care not to touch the inner surface of the package or the gloves. With the thumb and forefinger, grasp the folded cuff of the glove, insert fingers while pulling the glove over thee hand. Place the fingers of the gloved hand inside the cuff of the remaining glove and insert the fingers while stretching it over the hand. Adjust gloves on both hands if necessary, touching only sterile areas with other sterile areas.

When preparing to take a client's blood pressure, the nurse notes that the sphygmomanometer is visibly soiled. What is the correct action by the nurse? Discard the sphygmomanometer in the trash. Use the sphygmomanometer. Send the sphygmomanometer for sterilization. Cleanse and disinfect the sphygmomanometer.

Cleanse and disinfect the sphygmomanometer.

Nurses wear personal protective equipment (PPE) to protect themselves and clients from infectious materials. Which examples accurately represent the proper use of personal protective equipment in a health care agency? Select all that apply. Nurses may lower a mask around the neck when not being worn and bring it back over the mouth and nose for reuse. Nurses may use a waterproof gown more than one time. Nurses need only apply clean gloves when performing or assisting with invasive client procedures. To remove a gown, nurses should unfasten ties, if at the neck and back, and allow the gown to fall away from shoulders. Nurses should remove PPE at the doorway or in an anteroom, except for the respirator. During some care activities for an individual client, nurses may need to change gloves more than once.

During some care activities for an individual client, nurses may need to change gloves more than once. Nurses should remove PPE at the doorway or in an anteroom, except for the respirator. To remove a gown, nurses should unfasten ties, if at the neck and back, and allow the gown to fall away from shoulders.

Which nursing action carries the greatest likelihood of contributing to the spread of vancomycin-resistant enterococci (VRE)? Emptying the Foley catheter bag of a client with VRE and then helping the client in the next bed transfer to a chair without washing hands between contact. delivering a meal tray to a VRE-positive client without first donning gloves and a gown removing the staples from a VRE-positive, postoperative client's incision without prior handwashing sending a VRE-positive client to the radiology department for a chest X-ray without a face mask

Emptying the Foley catheter bag of a client with VRE and then helping the client in the next bed transfer to a chair without washing hands between contact.

A nurse follows surgical asepsis techniques for inserting an indwelling urinary catheter in a client. What is an accurate guideline for using this technique? Hold sterile objects above waist level to prevent inadvertent contamination. Open sterile packages so that the first edge of the wrapper is directed toward the nurse. Consider the outside of the sterile package to be sterile. Consider the outer 3-in. (8-cm) edge of a sterile field to be contaminated.

Hold sterile objects above waist level to prevent inadvertent contamination.

Which should be documented by the nurse? The fact that the nurse donned gloves two different times during a procedure The specific items that the nurse transferred into a sterile field The fact that the nurse washed her hands before a procedure The fact that sterile technique was used for a given procedure

The fact that sterile technique was used for a given procedure

The nurse is teaching a new nurse about preparing a sterile field. Which action made by the new nurse would indicate further teaching is required? The new nurse touches 1.5 in. (4 cm) from the outer edges. Direct visualization of the sterile field is maintained. The top flap of the package is opened away from the new nurse's body. The sterile field is set up at waist level.

The new nurse touches 1.5 in. (4 cm) from the outer edges.

Which nursing actions will be performed to assist in the prevention of health care-associated infections (HCAIs)? Select all that apply. Educate clients regarding why antibiotics are not used for viral illnesses. Recommend vaccinations to clients. Place clients with similar infectious diseases in the same room. Wash hands between caring for clients. Use personal protection equipment only for clients in isolation.

Wash hands between caring for clients. Recommend vaccinations to clients. Educate clients regarding why antibiotics are not used for viral illnesses.

The nurse is preparing a sterile field before providing a client with wound care. What is the nurse's most appropriate action?

When preparing a sterile field, the drape should be grasped by the corners, not by the middle. Contact should be limited to the outer 1 inch (2.5 cm) of the drape.

A client has an inguinal hernia repair and later develops a methicillin-resistant Staphylococcus aureus (MRSA) infection. What is the most important factor to prevent this infection? a. surgical asepsis b. increased vitamin C c. decreased antibiotics d. increased T cells

a

A nurse has sustained a puncture wound on the hand from a scalpel blade that was left on a used procedure tray. What is the first action by the nurse? a. wash the area with soap and water b. find out who left the scalpel blade on the procedure tray c. fill out a risk management form d. go to employee health for testing

a

An experienced nurse is teaching a student nurse about the proper use of hand hygiene. Which guideline should the nurse provide to the student? a. Hand hygiene is needed after contact with objects near the client. b. Hand lotions should not be used after hand hygiene. c. The use of hand hygiene eliminates the need for gloves. d. The use of gloves eliminates the need for hand hygiene.

a

Before and after doing aseptic techniques with a client, the nurse should: a. wash hands. b. apply clean gloves. c. replace equipment. d. sterilize equipment.

a

When a nurse picks up a client's contaminated tissue without gloves and fails to wash the hands sufficiently, the nurse provides for the client's organisms to be spread by which type of transmission? a. contact b. vector c. airborne d. vehicle

a

Which practice is a correct application of infection control practices? a. A nurse performs hand washing each time the nurse removes a pair of gloves. b. A nurse uses an alcohol-based hand rub each time that the nurse's hands are visibly soiled. c. A nurse dons a pair of gloves prior to any client contact. d. A nurse rinses hands thoroughly after the application of an alcohol-based hand rub.

a

The nurse manager for a long-term facility notes an increase in infection rates among residents. Which would be the best to implement? a. Restrict visitors to public places. b. Culture all residents and staff. c. All new residents are prescribed antibiotics. d. Review the current infection control protocols.

d

The nurse is receiving a confused client with a draining wound onto the medical-surgical unit. Which room assignment will the nurse make? with a client with a myocardial infarction with a client with pneumonia with another client with a draining wound into a private room

into a private room

A client comes to the emergency department reporting becoming very ill after consuming shrimp and lobster. How will the nurse document this condition? contagious disease noncommunicable disease infectious disease communicable disease

noncommunicable disease

The nurse is caring for a client who became very ill after ingesting seafood. How will the nurse document this condition? noncommunicable disease contagious disease infectious disease communicable disease

noncommunicable disease

A nurse is working with a 55-year-old woman diagnosed with human immunodeficiency virus (HIV). This nurse has another client that day who has an upper respiratory infection. What is the most important thing the nurse can do to prevent the client with HIV from acquiring the upper respiratory infection? wear a mask and gown in the client's room avoid direct contact with the client wear gloves when touching the client perform hand hygiene before and after entering the client's room

perform hand hygiene before and after entering the client's room

The nurse observes an unlicensed assistive personnel (UAP) collecting a urine specimen from a client with Staphylococcus aureus infection. Which action by the UAP would require the nurse to intervene? asks the client to state name and date of birth removes gloves and walks out of the room applies a mask with face shield performs hand hygiene before donning gloves

removes gloves and walks out of the room

Which is not appropriate regarding the use of gowns as PPE? donning a gown when splashing use of one gown per person per shift use of paper or cloth gowns use of a new gown each time the nurse enters the room

use of one gown per person per shift

Which care intervention should the nurse anticipate when providing care to a client admitted with a possible diagnosis of tuberculosis (TB)? wearing a particulate respirator for all client care and interaction wearing a face mask when entering and staying at a distance from the client placing the client in a regular, private room wearing protective eye wear for all client contact

wearing a particulate respirator for all client care and interaction

The patient has asked the nurse to explain her WBC level of 8,000 cells/mm3. The nurse would identify the level of WBCs as: decreased within normal limits elevated stable

within normal limits